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I heard I should be avoiding carbohydrates, is this true? This is 100% false! Carbohydrates are the body’s preferred source of fuel. Just as your car needs gas to run, your body and brain rely on carbohydrates to give you the physical and mental energy that you need to get through your day. What are carbohydrates actually? The majority of patients identify carbohydrates simply as grain products (e.g. bread, pasta, and rice). When dieters say they’re going on a low carb diet, they typically plan to eliminate or reduce their consumption of these grain products. In reality, carbohydrate sources include many other foods, like milk, yogurt, fruit, plenty of vegetables, and legumes. Did you know that one cup of milk has the same amount of grams of carbohydrates as a piece of toast? Or that a large apple has twice as many grams of carbohydrates as that same slice of toast? Or that a 1⁄2 cup of chickpeas has three times the amount of carbohydrates as the toast? Confused? This is why we challenge our patients in why they want to experiment with low-carbohydrate diets. What does that mean to them? And which foods are they planning on restricting? A lower carbohydrate diet is not necessarily a healthier one! In a world where our food apps can track everything, it’s sometimes hard to make sense of all of the numbers they give us. You shouldn’t be blindly trying to decrease your total grams of carbohydrates or total grams of fat per day without understanding how that translates into food choices and your overall health. The type of carbohydrate is more important than the amount of carbohydrate.Not all carbohydrates are created equal. The most common forms of carbohydrates are:  Fibre (for the purposes of this book, we will refer to fibre as a ‘complex carbohydrates’);  Sugar (for the purposes of this book, we will refer to them as ‘simple carbohydrates’).  Starch. Starch is calculated by taking the total carbohydrates and subtracting both the fibre and sugar from it (for the purposes of this book, we will refer to starches as ‘complex carbohydrates’). Foods that are high in carbohydrates but contain a fair amount of fibre and starch, and a low amount of sugar (i.e. high in complex carbohydrates and low in simple carbohydrates), are typically healthier choices. Complex carbohydrates take longer to digest, which is why they make you feel fuller longer. Examples include:  Barley;  Oats;  Quinoa;  Whole-grain products;  Legumes. Similarly, foods that are high in carbohydrates but contain high amounts of sugar and low amounts of fibre and starch (i.e. high in simple carbohydrates and low in complex carbohydrates) are typically less healthy choices. Simple carbohydrates are quickly digested, which is why they give you a quick boost of energy, but also why you don’t feel satisfied for very long. Examples include:  Pastries;  Donuts;  Chocolate;  Candy;  Juice;  Regular soda;  Sugary cereals. After WLS, protein should always be eaten first, followed by your vegetables and then your grain products (e.g. rice, quinoa, pasta) or starch (e.g. potato, sweet potato, squash). Eating in this order will naturally limit the amount of carbohydrates you consume at each meal because of the limited space in your stomach. Patients who restrict their carbohydrate intake, in our experience, typically have a harder time finding a healthy balance and joy in eating again. One of the biggest consequences of skipping out on carbohydrates at mealtime is that your blood sugar is less balanced, which can result in sugar cravings later on in the day. Remember: All foods fit, but it’s the portions of food that should be the focus in a healthy diet, post WLS. - Lisa & Monica

Try to see their side. You are asking them to see it from your perspective, so it is only fair that you try to see it from theirs. What are the reasons they may be against your Weight Loss Surgery, and how can you address them? In many cases, their concerns are legitimately about your well-being, and things you should consider if you have not already. They may worry that: You will not hit your goal weight this time since they’ve seen disappointment before. You will suffer complications from surgery. You will regret having a permanent Sometimes, their concerns are selfish but still worth discussing. They may worry that: You’ll stop feeling attracted to them. You will pressure them to give up their own favorite foods while you eat healthily. They will feel left out. You will not want to spend time with them. Reassure them. Address their concerns directly. Explain why you feel the surgery is safe, and how much research you have done to learn about it as well as find a surgeon. Tell them why you think Weight Loss Surgery will work for you even if previous diets have not. Let them know that you need to do this for yourself, not for them and that this will not change the way you feel about them – you will still love your SO, and respect your parents, for example. Tell them how you see yourself spending time with them after surgery, so they can be comfortable. Write it down and practice. Starting the conversation can be the scariest part of telling them. Before you bring up the subject, write down what you plan to say. This is a good exercise for you to do anyway since it encourages you to think through all of the doubts around Weight Loss Surgery. Writing it down and practicing can make it easier for the words to come when you decide to bring it up. Include them in your plans. Often, your spouse and parents, and others who care about you, just want to help. They may be afraid if they do not how to help. When you talk to them, let them know how important they are to you, both in life in general and in this important period of your life. If you tell them specifically what they can do to support you, they may feel more at ease with your decision and more confident in their roles. You might ask them to: Pick up your children from school when you are recovering from surgery. Go with you to the store to pick out protein powders and measuring cups and spoons. Ask you each night how you are doing. Cook healthy meals with you. Prepare for anything. The conversation may be as difficult and unfulfilling as you feared. Or, your SO, parents or other loved ones may be surprisingly supportive once they realize that you have done your research and are serious about making the lifestyle changes needed for success. They may even be interested in getting healthy with you and ask for your help and support in exchange for theirs. Stay strong and independent. As much as you long for your SO and other loved ones to support you wholeheartedly, it may not happen. Try not to let it get you down, though. If you are sure about what you want, go for it, with or without them. They will come around sooner or later, and if not, you may be better off without their negative influence. Letting them know that you have made up your mind regardless of their support may actually convince them to help you since there is no point in standing in your way. Stay independent in the sense that you realize that you do not need them. Your success does not depend on their approval, and you are not doomed to fail if they stand in your way. Get the support you need from others as you move forward.

How you may wonder, can you make this the most wonderful time of the year if you cannot celebrate it with the same food, drink, and abandon that you may have before your WLS journey started? Keep your chin up! We’re not promising that these holidays will be the same as ever, but you can make them great. They may even be better! Here are our thoughts on loving the holidays while staying healthy. We’re Not in Kansas Anymore! As with the rest of your life, the success of the holidays can no longer best be measured by how much you ate. There is so much more to it than that! Now, pleasure from food contributes to “success,” but so do so many other things, including the activities you do, the quality of your time with loved ones, and the pride you have in yourself. Give up your former conceptions of what holiday happiness is, and you will have a lot to gain (but not weight). Just Say, “No!” – But How? There is no denying that a good deal of the holiday cheer – and the holiday struggle – revolves around food. Eat it with abandon, and you will set yourself back months. You are almost sure to be offered more than you should eat and foods that are not on your diet, so you will need to learn to say no. Be prepared with different ways to say, “No,” without hurting anyone’s feelings, and practice the before-hand so you are not caught off guard. “No, thanks.” “No, thanks. I’m not hungry.” (If you’re in the middle of lunch so you cannot claim that you are not hungry:) “No, thanks. It’s not in my diet.” “I would love to, but my doctor said I cannot have that!” “Thank you! How kind! I will save it for later.” Later, give it to someone who will love it. Be Confident. Be polite but firm when refusing food or insisting on getting in your afternoon walk. You may be surprised at how easily people accept your decisions. They may even make them easier once they see you are serious by, for example, offering to bring you a diet-friendly version of a treat or asking to come on your walk. If you waver initially, though, they may not take you seriously, and instead, keep prodding you to abandon your good intentions. Be Proud of Yourself. A barrier to success that is present year-round, but more intense during the holiday season, is the natural desire to help others – and this can come with a feeling of guilt if making your health a priority makes you worry that you are not giving your best to your family. Remember that you can give your best only when you are at your best, and to be at your best, you need to be healthy. You will have more energy, think more clearly, and even be happier when you are taking steps towards health, and all that will enable you to give more to others. You Are Not Alone The grass may seem greener on the other side of the fence, but is it really? It probably is not, even though you may feel that your holiday season is hard while others have it easy. The truth is that millions of others are facing the same challenges as you. Even people who appear not to have weight problems are sure to have major concerns in their lives. They may be fighting just as hard as you to avoid eating the whole pie, or they may have non-food challenges. You do not know, but what you can safely assume is that everyone has challenges. You will feel better about yourself if you always treat others with respect and not with jealousy. Rather than feeling sorry for yourself, you might as well embrace the holidays for what they are worth: an opportunity to overcome hurdles and strengthen yourself; a magical time of year when people come together; and a chance to experience new feelings and participate in new activities that may not have been possible before you got serious about your health.

You may also be wondering how in the world do I become more active? I don’t even know where to start, and the gym just isn’t for me. We teamed up with Myriam, a local kinesiologist, to give you tips on how to start to get your joints moving when you’ve been inactive for too long. A kinesiologist is a highly educated health care professional who is an expert in body movement. They’re experts in preventing and managing injuries and help people to get fit and perform at their best, among many other things. In these videos, Myriam will show you exercises that you can do at home to improve the health of your joints and movement to start getting you on a path to being more fit. Practice these exercises in the comfort of your own home. All you’ll need is: A chair, A belt or resistance band, A broomstick or long stick. These exercises are great to start BEFORE surgery, early AFTER surgery, or even LONG TERM after surgery. It’s never too late to start being active. Remember that the number on the scale is only part of the story – fitness and exercise is the other half of the equation when it comes to living a longer and healthier life. How did this activity go for you? Let us know! – Lisa & Monica